Arch P(diatr (1995) 2, 333-338 © Elsevier. Paris 333 Fait clin~que La pince aortom6sent~rique sup~rieure primitive JP Bonnet ~', D Louis ~, P Foray 2 i Service de chirurgie p~diatrique, 2strvice de radiop£'diatrie, h(JpitalDebrousse, 29. rue Sceur-Bouvier, 69322 Lyon Cedex 05. France (Requ le 22 f6vrier 1994; accept6 le 30 septembre 1994) R*~.sum~ Le diagnostic de pince aortom~seut~rique sup6rieure primitive a grandement b6n~fiei~ de techniques radiologiques modernes telles que l'6chographie et le scanner. Observation. - Un garcon de 11 ans a 6t6 hospitalis6 pour vomissements bilieux apparus depuis 24 heures. Le diagnostic de pince aortom6sent6rique SUl~rieure a 6t6 port6 -~ partir des nSsultats de rexamen radiologique de l'abdomen sans pr6paration, de l'6chographie et de l'opacification gastroduod6nale • la baryte fluide. L'~chographie avail montr6 une augmentation du diam~tre de la veine r6nale gauche. L'enfant a 6t6 plac6 sous alimentation fractionn6e et en d6cubitus lat6ral gauche. Le scanner r~alis6 5 jours plus lard a confirm6 le .iagnostic mais n'a pas montr6 de dilatation de la veine r6nale gauche. Cot enfant va parfaitement bien I an plus tard, sans traitement di~t6tique ni postural. L'~chographie s6alis6e alors, 3 heures apr~s un repas, a montr6 los m~mes signes que lot's de la phase aigu~. Conelusions. - Le scanner et l'6chographie repr6sentent des techniques int6ressantes pour le diagnostic d'un tel syndrome. La vzieur diagnostique d'une dilatation de la veine r6nale gauche reste ~ d6montrer. pince aortom~.sent~rique I attire m~sent~rique sup~rieure / occlusion duod~nale / ~chographie / tomodensitom~trie Summary - Superior mesenteric artery syndrome in a child. Background. - Early diagnosis of superior mesenterie artery syndrome, less frequent in children than in young adults, is improved by the use of ultrasonography and CT scan. Case report.- An eleven year-old boy was admitted because he suffered from bilious vomiting for 24 hours. A diagnosis of superior mesenteric artery syndrome ~vas made from the results of plain films of the abdomen, ultrasonography and roentgenograms after instillation of dilute barium solution. Diameter of the left renal vein appeared increased. The patient was given fractionated meals and placed in left lateral positon. The CT scan performed 5 days later confirmed the diagnosis but did not show dilatation of the left renal vein. The patient is well one year later without treatment. Ultrasonography performed 3 hours after a meal showed similarfindings to those seen in the acute phase. Conclusion. - Abdominal scanning and ultrasound are valuable tools for diagnosis of such a syndrome. The diagnostic value of dilatation of the left renal veir: remaitLs to be determined. splanchnic circulation / supe,'ior mesenteric artery syndrome / ultrasonic diagnosis I tomography, X-ray computed / child *Correspondance et tir~s fi part: JP Bonnet, service de chirurgie infantile, centre hospitalier. I. rue Jean-Moulin. 95160 M;~ntmorency.